Comparison of the effects of sevoflurane and halothane on the quality of anaesthesia and serum glutathione transferase alpha and fluoride in paediatric patients

Abstract

We have compared sevoflurane and halothane anaesthesia in paediatric patients with reference to induction and recovery. We also assessed hepato-cellular integrity by measurement of serum gluta-thione transferase alpha (GSTA) concentration and sevoflurane metabolism by serum fluoride concentration. Fifty unpremedicated 5-12-yr-old children were allocated randomly to induction of anaesthesia via a face mask with 66% nitrous oxide in oxygen and sevoflurane (up to 7%) or halothane (up to 3.5%). Anaesthesia was maintained for 1.8 h at 1-1.2 MAC of the volatile agent. Children receiving sevoflurane had significantly faster induction and recovery variables than those receiving halothane. There was a small postanaesthetic increase in GSTA in both groups, suggesting that halothane and sevoflurane may disturb hepato-cellular integrity. Serum concentrations of fluoride were significantly greater after sevoflurane than after halothane anaesthesia. There were no clinical signs or symptoms of hepatic or renal disturbance. Children tolerated sevoflurane better than halothane, which may have been because of the non-pungency of sevoflurane and the rapid psycho-motor recovery after anaesthesia. © 1994 British Journal of Anaesthesia.